Ventricular tachycardia secondary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
==[[Secondary prevention]]== | ==[[Secondary prevention]]== | ||
<span style="font-size:85%">'''Abbreviations:''' | |||
'''MI:''' [[Myocardial infarction]]; | |||
'''VT:''' [[Ventricular tachycardia]]; | |||
'''VF:''' [[Ventricular fibrillation]]; | |||
'''LVEF:''' [[Left ventricular ejection fraction]]; | |||
'''ICD:''' [[Intracardiac defibrillation]]; | |||
'''NYHA:''' [[New York Heart Association]] functional classification; | |||
'''LVAD:''' [[Left ventricular assist device]]; | |||
'''EPS:''' [[Electrophysiology study]] | |||
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| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center |'''Recommendations for secondary prevention of sudden cardiac death in ischemic heart disease''' | |||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left | '''[[ICD]] implantation ([[ACC AHA guidelines classification scheme|Class I, Level of Evidence B]]):''' | |||
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❑ In [[patients]] with [[IHD]] and survivors of [[SCD]] due to [[vt]], [[vf]] or hermodynamically unstable [[VT]] or incessant [[VT]] with irreversible cause, [[ICD]] should be implanted if survival is more than 1 year. | |||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''[[ICD]] implantation ([[ACC AHA guidelines classification scheme|Intermediate value statement, Level of Evidence B]]) :''' | |||
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❑ In [[patients]] with high risk of [[death]] due to [[ventricular arrhythmia]] and low risk of non [[cardiac]] death due to other [[comorbidities]], [[ICD]] implantation has intermediate value. | |||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''[[ICD implantation]] : ([[ACC AHA guidelines classification scheme|Class I, Level of Evidence B]])''' | |||
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❑ In [[patients]] with [[IHD]] | |||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''([[ACC AHA guidelines classification scheme|Class III, Level of Evidence C]])''' | |||
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❑ [[ICD ]] is not beneficial in patients with [[NYHA]] class 4 despite optimal medical therapy who are not candidates for [[cardiac transplantation]] or [[LVAD]] | |||
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{{Family tree | | | | | | | A01 | | | | A01=Secondary prevention in patients with [[IHD]]}} | {{Family tree | | | | | | | A01 | | | | A01=Secondary prevention in patients with [[IHD]]}} | ||
Revision as of 11:20, 12 May 2021
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Ventricular tachycardia Microchapters |
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Differentiating Ventricular Tachycardia from other Disorders |
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Ventricular tachycardia secondary prevention On the Web |
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to Hospitals Treating Ventricular tachycardia secondary prevention |
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Risk calculators and risk factors for Ventricular tachycardia secondary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in Chief: Avirup Guha, M.B.B.S.[2]
Overview
Secondary prevention
Abbreviations:
MI: Myocardial infarction;
VT: Ventricular tachycardia;
VF: Ventricular fibrillation;
LVEF: Left ventricular ejection fraction;
ICD: Intracardiac defibrillation;
NYHA: New York Heart Association functional classification;
LVAD: Left ventricular assist device;
EPS: Electrophysiology study
| Recommendations for secondary prevention of sudden cardiac death in ischemic heart disease |
| ICD implantation (Class I, Level of Evidence B): |
|
❑ In patients with IHD and survivors of SCD due to vt, vf or hermodynamically unstable VT or incessant VT with irreversible cause, ICD should be implanted if survival is more than 1 year. |
| ICD implantation (Intermediate value statement, Level of Evidence B) : |
|
❑ In patients with high risk of death due to ventricular arrhythmia and low risk of non cardiac death due to other comorbidities, ICD implantation has intermediate value. |
| ICD implantation : (Class I, Level of Evidence B) |
| (Class III, Level of Evidence C) |
|
❑ ICD is not beneficial in patients with NYHA class 4 despite optimal medical therapy who are not candidates for cardiac transplantation or LVAD |
| Secondary prevention in patients with IHD | |||||||||||||||||||||||||||||||||||||||||||||
| SCA survivor or sustained monomorph VT | Cardiac syncope | ||||||||||||||||||||||||||||||||||||||||||||
| Ischemia | LVEF≤35% | ||||||||||||||||||||||||||||||||||||||||||||
| Yes: revascularization, reassessment about SCD risk (class1) | NO:ICD candidate | ||||||||||||||||||||||||||||||||||||||||||||
| Yes:ICD (class1) | NO: medical therapy (class1) | Yes:ICD (CLASS1) | NO:EP study (class 2a) | ||||||||||||||||||||||||||||||||||||||||||
| Ventriculat arrhythmia induction | |||||||||||||||||||||||||||||||||||||||||||||
| Yes: ICD (class1) | NO: monitoring | ||||||||||||||||||||||||||||||||||||||||||||